Amy Romano, a Certified Nurse Midwife, mother of two and multiple venue contributor to Lamaze publications, including the blog Science and Sensibility is a fantastic example of a woman on a mission. In short, she is working to make improvements to the maternity care system in our country.
Amy recently invited me to participate in a Bloggers Carnival regarding the Lamaze International organization’s sixth Healthy Birth Practice: Keep Mother and Baby Together (following birth): It’s Best for Mother, Baby, and Breastfeeding
This particular topic reminds me of the dozens of conversations I’ve been involved in–with my own students and with childbirth education colleagues of mine– regarding how to maintain mother-baby contact following a cesarean section birth.
The research on this issue is crystal clear: babies do better in the first minutes, hours and days, the more time they spend in skin-to-skin contact with their mothers. Their breathing and heart rates remain more stable. Their body temperatures fluctuate less. Ditto for their blood sugar levels. They cry less and they nurse and sleep better, too.
In her wildly successful book, A Thinking Woman’s Guide to a Better Birth, birth activist Henci Goer pulls together data from multiple national and international studies that all report similar findings with newborn decreased APGAR scores, respiratory rate variability and poor oxygenation, in the event of a cesarean birth. Basically, a baby born by c-section loses out on the pressures associated with a normal, vaginal birth–pressures that result in massaging and squeezing excess amniotic fluid from her lungs, enabling improved air flow and oxygenation.
So, if a baby born by c-section is already three times as likely to suffer breathing difficulties than his vaginal birth equivalent, why would we would make it common practice to separate mom and baby seconds after the birth, when maintaining mother-baby skin-to-skin contact improves the very functions threatened by the cesarean process? Is it not equally possible for someone (dad/partner/nurse/doula/etc./etc.) to lift away mom’s hospital gown and help hold baby skin-to-skin on mom’s chest while the cesarean procedure is completed, thus helping to stabilize the infant in the moments following his birth?
Another hurdle to maintaining close contact between mom and baby following a cesarean is the question of anesthesia. Depending on the hospital in which a woman is giving birth, it may be very likely a common practice for the woman to receive an IV sedative following her baby’s birth–forcing her into a “twilight” sleep for the remainder of her surgery, and rendering her groggy (and sometimes violently nauseated) for upwards of two hours thereafter. With mom cast off into la-la land and baby whisked away to the nursery, some mother-baby duos find themselves separated for upwards of two hours after birth–a critical time when skin-to-skin contact would otherwise facilitate stabilization of baby’s vital signs, mother-baby bonding, initiation of nursing (which, by the way, significantly slows mom’s uterine bleeding) and stabilization of the woman’s birth and post-birth hormonal fluctuations.
In the Lamaze classes I taught up in Bozeman, I got to the point that I encouraged expectant parents to ask for several things in the event a cesarean delivery became imminent:
1. Request baby be placed on mom’s chest following delivery AS SOON AS POSSIBLE and perform any support measures for baby at that location (yes, the anesthesiologist will have his or her space cramped up at the head of the operating table but they can cope if they really want to).
2. Request that mom NOT be given a sedative of any sort (she will be entirely numb from nipple line down due to a spinal block, anyway) during or following the surgery. Encourage other relaxation measures if anxiety surrounding surgery should arise: relaxation breathing, soft music in the OR, partner and/or doula present near mom’s head at all times…
3. If separation of mom and baby DOES occur for any reason (newborn needing extra resuscitation measures, etc.) request reunion between mom and baby within no more than 30 MINUTES of birth, and make sure baby goes directly to recovery room with mom, rather than to the nursery.
4. Request two people accompany mom into operating room, such as her spouse/partner and a doula, midwife, friend or other family member so that there is plenty of emotional support and advocacy for maintaining mother-baby contact following birth.
With the national rate of cesareans creeping upwards of 30%, there are a lot of moms and newborn babes out there who are missing out on important minutes and hours of each others’ time…unless educated consumers LIKE YOU start requesting different practices.
Do me a favor, pass the link to this post along to anyone who will at some point, has, or is about to give birth. Join the conversation. Make your voice heard.